A Battle of Coding Experts

Posted By Robert Sparks || Feb 4, 2013

Florida personal injury cases will begin to see a new practice at trial. This new practice will be in the form of experts providing testimony on medical billing, coding, and documentation. In short, as a result of a recent appellate decision, personal injury litigation (specifically in Florida
car accident cases) will begin to see coding experts listed on defense witness lists for trial.

A coding expert analyzes whether the services reflected in a provider’s bill are also reflected in a provider’s medical record documentation. The coding expert will be retained (typically by the defense) to analyze and opine whether the providers’ charges are reimbursable. In an auto accident case, cost experts can be distracting, time consuming, and costly for the injured plaintiff to defend against.

The ability of the coding expert to testify in a Florida auto accident case was recently addressed by Florida’s Second District Court of Appeal. See State Farm Mut. Auto Ins. Co. v. Bowling, 81 So.3d 538 (Fla. 2d DCA 2012). In the Bowling case, the trial court granted the Plaintiff’s motion to exclude the coding expert’s testimony, finding that the testimony of the witness would not assist the jury in determining whether Mr. Bowling’s medical bills are reasonable and that the expert was not qualified to render an opinion as to the reasonableness of those medical bills.

The Second DCA reversed the trial court and remanded the case for a new trial on damages. The Second DCA held that the expert’s testimony was admissible under Florida Statutes Section 90.702, and reasoned that the expert’s opinion would have assisted the jury. Specifically, it would have assisted the jury in determining whether the Plaintiff’s medical bills accurately reflected the treatment he was documented to have received. The Second DCA also acknowledged that the expert did not have the necessary medical background to render an opinion on whether the medical care allegedly provided to the Plaintiff was reasonable but this does not alone stop the expert from testifying about the medical bills submitted by the medical providers.

This opinion, while minor in some aspects, could have a wide reaching effect on automobile litigation. Plaintiffs can expect that insurance companies will engage coding experts on all trial cases in hopes of increasing the expense of litigation for the Plaintiff’s and in an effort to reduce an award of damages. In the event you have a question regarding a car accident case, or if you have been the victim of negligence, please do not hesitate to contact Givens Givens Sparks for a free case evaluation.

The information on this website is for general information purposes only.
Nothing on this site should be taken as legal advice for any individual
case or situation. This information is not intended to create, and receipt
or viewing does not constitute, an attorney-client relationship.